It really is the million dollar question in my women's health Physio clinic and I was in exactly the same position after having my very big baby and putting on loads of weight in pregnancy!
This has led me to doing lots of research on this topic. I particularly wanted to know why most of the women that I treat with urinary incontinence all have almost EXACTLY the same posture. Skinny arms and legs, a small bum (it has usually decreased in size since pre pregnancy), a flattening of the stomach about 4 fingers underneath the ribcage often with a crease along the abdomen, and then a 'pouch' in the front of the belly. When looking at them side on, the tailbone is tucked underneath and the flattening at the top of the abdomen and the pouch below it and around the umbilicus are particularly evident and their weight is through their heels when standing.
Anyways. I have found the answer!
Most women are over recruiting their upper most external oblique abdominal muscles because they are conscious of their bigger bellies post pregnancy and constantly sucking their tummys in. This is then making them tuck their tailbones underneath of them which doesn't allow their gluteal muscles to activate and makes the bum smaller. Anytime we cough, laugh or sneeze we get increased pressure in the abdomen and this pressure has to bulge somewhere (imagine a balloon being squeezed), and when the external obliques, that are just below the ribs are constantly being over recruited, we get an uneven distribution in the pressure and it bulges forwards in front of the abdomen and makes the Mum pouch.
This constant over recruitment of the external obliques also puts a downward pressure onto the pelvic floor and weakens it over time, which can result in urinary incontinence! I also find that women who have this flattening find it VERY difficult to fully relax their pelvic floor, so often have a tight weak pelvic floor.
SO if you have a Mummy Tummy:
1) Relax you uppermost abs!
2) Untuck your tailbone and stick your bottom out a little
3) Make sure you have had your tummy muscle separation checked by a women's health physio as this could be messing with the pressure distribution in your belly too.
4) Avoid sugar (especially if you feel stressed) as cortisol and sugar = tummy fat.
5) Get your pelvic floor muscle strength assessed by a WH physio after you have had a baby as the abdominals, diapraghm, deep back muscles and PF are so closely linked in the way that work together to deal with the increased pressures involved in coughing, laughing, lifting and sneezing!
6) See a WH physio BEFORE you have any problems! 1 in 3 women in the UK have urinary incontinence
WH Physiotherapist, LuluJay Physiotherapy, SW181TF